HomeMy WebLinkAboutElliott, Robert DS-DE 9 - New Bank (2020 08 14)APPOINTMENT OF CAMPAIGN TREASURER RECEIVED
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES AH '1 4,
(Section 106.021(1), F.S.)
(PLEASE PRINT OR TYPE)
NOTE: This form must be on file with the qualifying
officer before o enin the caiiiiil"illl"lll'Daiiii,in account. OFFICE USE ONLY
1. CHECK APPROPRIATE BOX(ES):
❑ Initial Filing of Form Re -filing to Change: ❑ Treasurer/Deputy Xl Depository ❑ Office ❑ Party
2. Name of Candidate (in this order: First, Middle, Last) 3. Address (include post office box or street, city, state, zip
Robert M Elliott code)
925 Chokecherry Court
4. Telephone 5. E-mail address Winter Springs, FL 32708
(407 ) 848 9828 elliotr86899gmail.com
6. Office sought include district, circuit, group numb r)
City Commissioner - District 5
7. If a candidate for a non artisan office, check if
applicable:
❑ My intent is to run as a Write -In candidate.
8. If a candidate for a R@111san office, check block and fill in name of party as applicable: My intent is to run as a
0 Write -In ❑ No Party Affiliation
9. 1 have appointed the following person to act as my
10. Name of Treasurer or Deputy Treasurer
Sarah A Elliott
11. Mailing Address
925 Chokecherry Court
Party candidate.
0 Campaign Treasurer ❑ Deputy Treasurer
13. City 14. County 15. State 16. Zip Code
Winter Springs Seminole FL 32708
12. Telephone
( 407 ) 314 6922
17. E-mail address
ellioft8689@gmaii.com
18. 1 have designated the following bank as my ® Primary Depository ❑ Secondary Depository
19. Name of Bank
Citizens Bank of Florida
21. City 22. County
Oviedo Seminole
1�iFL
m.m -- -- � � _ ....... ......._.
Bug Lake Road
3. State 24. Zip Code
, 32765
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING FORM FOR APPOINTMENT OF CAMPAIGN TREASURER AND
DESIGNATION OF CAMPAIGN DEPOSITORY AND THAT THE FACTS STATED IN IT ARE TRUE.
25. Date Signature ........._....w_.... ............� nature26. Si . _.._.. .....�M- ..__
of"ndidate
8/13/2020
27. Treasurer's Acceptance of Appointment (fill in the blanks and check the appropriate block)
Sarah A Elliott do hereby accept the appointment
(Please Print or Type Name)
designated above as: 0 Campaign Treasurer ❑ Deputy Treasurer.
8/13/2020
Date
ure of Campaign 1 reasurer or ueputy I reasurer
Rule 1S-2.0001, F.A.C.
DS-DE 9 (Rev. 10/10)